Celecoxib

Celecoxib  is a non-steroidal anti-inflammatory drug (NSAID) used in the treatment of osteoarthritis, rheumatoid arthritis, acute pain, painful menstruation and menstrual symptoms, and to reduce numbers of colon and rectum polyps in patients with familial adenomatous polyposis. It is marketed by Pfizer under the brand name Celebrex. In some countries, it is branded Celebra. Celecoxib is available by prescription in capsule form.

Indications

Celecoxib is licensed for use in osteoarthritis, rheumatoid arthritis, acute pain, painful menstruation and menstrual symptoms, and to reduce the number of colon and rectal polyps in patients with familial adenomatous polyposis. It was originally intended to relieve pain while minimizing the gastrointestinal adverse effects usually seen with conventional NSAIDs. In practice, its primary indication is in patients who need regular and long term pain relief: there is probably no advantage to using celecoxib for short term or acute pain relief over conventional NSAIDs. In particular, the pain relief offered by celecoxib is similar to that offered by paracetamol.

Availability

Pfizer sells Celecoxib under the brand name Celebrex. Celecoxib is not currently available generically in the United States, because the intellectual property is still controlled by Pfizer. Generic Celecoxib pills are produced legally in some countries and illegally in others, and are often sold to customers in the United States and elsewhere through web-based stores.

Pharmacology

Celecoxib is a highly selective COX-2 inhibitor and primarily inhibits this isoform of cyclooxygenase (inhibition of prostaglandin production), whereas traditional NSAIDs inhibit both COX-1 and COX-2. Celecoxib is approximately 7.6 times more selective for COX-2 inhibition over COX-1. In theory, this specificity allows celecoxib and other COX-2 inhibitors to reduce inflammation (and pain) while minimizing gastrointestinal adverse drug reactions (e.g. stomach ulcers) that are common with non-selective NSAIDs.

Dosing

The usual adult dose of celecoxib is 100 to 200mg once or twice a day. The lowest effective dose should be used.